Changes in the multidisciplinary management of rectal cancer from 2009 to 2015 and associated improvements in short‐term outcomes

Aim: Significant recent changes in management of locally advanced rectal cancer include preoperative staging, use of extended neoadjuvant therapies, and minimally invasive surgery (MIS). This study was aimed at characterizing those changes and associated short‐term outcomes. Method: We retrospectively analysed treatment and outcome data from patients with T3/4 or N+ locally advanced rectal cancer ≤15 cm from the anal verge who were evaluated at a comprehensive cancer center in 2009–2015. Results: In total, 798 patients were identified and grouped into five cohorts based on treatment year: 2009‐2010, 2011, 2012, 2013, and 2014‐2015. Temporal changes included increased reliance on MRI staging, from 57% in 2009‐2010 to 98% in 2014‐2015 (p < 0.001); increased use of total neoadjuvant therapy, from 17% to 76% (p < 0.001); and increased use of MIS, from 33% to 70% (p < 0.001). Concurrently, median hospital stay decreased (from 7 to 5 days; p < 0.001), as did the rates of grade III‐V complications (from 13% to 7%; p < 0.05), surgical site infections (from 24% to 8%; p < 0.001), anastomotic leak (from 11% to 3%; p < 0.05), and positive circumferential resection margin (from 9% to 4%; p < 0.05). TNM downstaging increased from 62% to 74% (p = 0.002). Conclusion: Shifts toward MRI‐based staging, total neoadjuvant therapy, and MIS occurred between 2009 and 2015. Over the same period, treatment responses improved, and lengths of stay and the incidence of complications decreased

Role of nitric oxide and prostaglandins in the potentiating effects of calcitonin gene-related peptide on lipopolysaccharide-induced interleukin-6 release from mouse peritoneal macrophages

Previous data from our laboratory have shown that calcitonin gene-related peptide (CGRP) has a potentiating effect on lipopolysaccharide-(LPS) induced interleukin-6 (IL-6) release from mouse macrophages. However, the mechanism of this effect was not clear. Since the nitric oxide (NO) and prostaglandins (PGs) induced by LPS might modulate IL-6 release, we examined whether NO and PGs were also involved in the potentiating effect of rat CGRP (rCGRP) on LPS-induced IL-6 release from mouse macrophages. The IL-6 level in the medium was measured by enzyme-linked immunosorbent assay. Accumulation of NO was assessed by measuring the presence of nitrite by the Greiss reaction. PGI2 was assessed by measuring the formation of 6-keto-prostaglandin F1α (6-keto-PGF1α) by radioimmunoassay. The results showed that the potentiating effect of rCGRP (0·1 nm) on LPS-induced IL-6 release was significantly inhibited by either 100 μm NG-monomethyl-l-arginine acetate (l-NMMA; an inhibitor of NO synthase) or 10 μm indomethacin (an inhibitor of cyclo-oxygenase). The LPS-induced NO and PGI2 production from these cells was increased significantly by rCGRP at 0·01–10 nm in a concentration-dependent manner, which was blocked by l-NMMA and indomethacin. These results suggest that rCGRP enhances the NO production elicited by LPS and subsequently increases the PGs production which is involved in the potentiating effect of rCGRP on LPS-induced IL-6 release from the peritoneal macrophages in the mouse

Leaf digestibility and litter decomposability are related in a wide range of subarctic plant species and types

1. Herbivory and litter decomposition are key controllers of ecosystem carbon and nutrient cycling. We hypothesized that foliar defences of plant species against vertebrate herbivores would reduce leaf digestibility and would subsequently, through 'afterlife effects', reduce litter decomposability. 2. We tested this hypothesis by screening 32 subarctic plant species, belonging to eight types in terms of life form and nutrient economy strategy, for (1) leaf digestibility in cow rumen juice; (2) biochemical and structural traits that might explain variation in digestibility; and (3) litter mass loss during simultaneous incubation in an outdoor subarctic litter bed. 3. Interspecific variation in green-leaf digestibility corresponded significantly with that in litter decomposability; this relationship was strongly driven by overall variation among the eight plant types (r = 0.92). The same relationship was not detectable within plant types in taxonomic relatedness tests. 4. Several biochemical and structural parameters (phenol-to-N ratio, lignin-to-N ratio) explained a significant part of the variation in leaf digestibility, but again only between and not within plant types. 5. Our results provide further support for the role played by foliar defence in the link between plant and soil via the decomposition pathway. They are also a new example of the potential control of plant functional types over carbon and nutrient dynamics in ecosystems

The role of homophase and heterophase interfaces on transport properties in structured materials

In structured or self-organized materials spatial confinement effects lead to structure- and interface-controlled modifications of the bulk transport properties. In part, such modifications can be accounted for by a classical master equation approach for the transport of the different charge carrier species. The rather large quantity of parameters, which enter such an approach, can more or less easily be adjusted to the dimensional characteristics, local potential changes at interfaces, and the electronic settings of the system as well as to temperature effects. On the other hand, a microscopically more detailed and mostly parameter-free picture is obtained from a quantum-mechanical treatment on the basis of the density-functional theory. An extension by a Green's function formalism allows the determination and analysis of electronic transport through contacted nanostructures. Examples will be given to demonstrate the applicability of the different approaches for dissipative and hopping transport through a regular array of nanostructures, for a mechanically triggered metal-insulator transition in nanowires, and for the enhanced conductivity at multiferroic domain walls